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PubMed2005

Erosive effects of common beverages on extracted premolar teeth.

BACKGROUND: Dental erosion is highly prevalent today, and acidic drinks are thought to be an important cause. The aim of the present investigation was to determine the erosive potential of a range of common beverages on extracted human teeth. METHODS: The beverages were tested for their individual pHs using a pH meter. The clinical effects of the most erosive beverages were determined by the degree of etching and Vickers microhardness of enamel. RESULTS: The results showed that many common beverages have pHs sufficiently low to cause enamel erosion. Lime juice concentrate (pH 2.1) had the lowest pH, followed by Coca-cola and Pepsi (both with pH 2.3) and Lucozade (pH 2.5). The erosive potential of these beverages was demonstrated by the deep etching of the enamel after five minutes. The Vickers Hardness of enamel was reduced by about 50 per cent in the case of lime juice (p < 0.001) and 24 per cent in the case of Coca-cola (p < 0.004). Addition of saliva to 50 per cent (v/v) of Coca-cola completely reversed the erosive effects on the enamel. CONCLUSIONS: Although only a few of the beverages with the lowest pHs were tested, the present study showed that the most acidic drinks had the greatest erosive effects on enamel. While saliva was protective against erosion, relatively large volumes were required to neutralize the acidity.

Acids↗
PubMed2001

[The erosive potential of various oral care products compared to foodstuffs and beverages].

The purpose of the present study was to investigate the erosive potential of various oral care products and to compare the results with those of various foodstuffs and beverages. Furthermore, the chosen method of surface hardness measurements was compared with scanning electron microscopy. Seven oral care products (toothpastes and mouth rinses), three foodstuffs and one beverage (as positive control) were tested for their erosive potential. After initial hardness testing 110 enamel specimens were distributed into 11 groups of 10 specimens each in such a way as to have a homogenous hardness distribution per group. The erosive potential of the products was tested by immersing the enamel specimens into solutions of the various products for 10 and 20 minutes. After the experimental period Knoop hardness was measured on the enamel specimens and the differences between before and after were calculated. The micromorphology of native enamel surfaces before and after immersion was determined by SEM on further enamel specimens treated identically for 20 minutes. Apple puree and orange juice produced the most marked losses of hardness after 10 and 20 minutes, respectively. Among the dental hygiene products only the fluoride-free Weleda toothpaste produced a significant reduction of hardness after 10 as well as after 20 minutes. With the exception of Elmex-Gel, all tested dental hygiene products led to a significant (p<0.05) increase of enamel hardness. The results of the hardness measurements corresponded with the micromorphological findings. It may, therefore, be concluded that the tested fluoride-containing oral care products do not exhibit any erosive potential which could be measured with the methodology used in this investigation.

Beverages↗
PubMed1991

Dental erosion and associated factors among factory workers exposed to inorganic acid fumes.

The occurrence of dental erosion and the relative importance of some related factors were explored in a cross-sectional study, using blind dental examinations. A sample of 186 workers from four factories was drawn. Among the 157 dentate participants 76 were working in departments containing acid fumes and 81 controls had never worked under such conditions. Out of the dentate participants, 20 (12.7% had erosion). Anterior teeth were affected more often than posterior ones. Exposure to acid fumes, increasing age and frequency of intake of fruits increased the probability of dental erosion. It can be concluded that exposure to acid fumes in the work environment is associated with dental erosion especially on anterior teeth.

Acids↗
PubMed1989

Effects of various sport drink modifications on dental caries and erosion in rats with controlled eating and drinking pattern.

A sport drink mixture, pH 3.2, containing 6% sucrose, was given to Osborne-Mendel rats, either as such or supplemented with 15 ppm fluoride, 38.5 ppm magnesium or both. Distilled water was given to the control groups. The rats were fed either a slightly cariogenic, powdered food containing 15% sucrose, or commercial pellets. Food and drink were available ad libitum for 6 weeks. A feeding machine was used to facilitate control of eating and drinking pattern. Daily intake of powdered, sugar-containing food was significantly smaller than that of pellets and, on the other hand, sport drink was consumed significantly more than distilled water. However, an appropriate energy balance was achieved with all of the dietary combinations, and no significant differences in weight gains were found. Sport drink did not significantly promote caries but induced marked erosion on the lingual surfaces of the lower molar teeth. Addition of fluoride to the sport drink significantly reduced caries (caused by powdered food) and had preventive effect on erosion, while addition of magnesium had no clear effect on either caries or erosion. No significant intergroup differences were found in eating or drinking patterns due to fluoride or magnesium additions.

Animals↗
PubMedDate not supplied

Influence of in vivo formed salivary pellicle on enamel erosion.

This study assessed the protective effect of the salivary pellicle formed in vivo during 24 h or 7 days against demineralization of bovine enamel caused by citric acid. In addition, the influence of acid treatment on the behavior of the pellicle was investigated. Enamel specimens with and without in vivo pellicles were immersed in citric acid (0.1, 1.0%) over 30, 60, and 300 s, and processed for scanning (SEM) and transmission electron microscopy (TEM), as well as for measurement of surface microhardness (SMH). Specimens coated with the in vivo formed pellicles revealed less extensive erosive demineralization of the enamel surface compared to uncovered enamel specimens. SEM analysis and SMH results did not indicate distinct differences between erosive surface alterations on enamel slabs covered with 24-hour pellicles and on those covered with 7-day pellicles. TEM analysis showed that the pellicle layer was dissolved in part from the enamel surface due to acid exposure. However, pellicle residues could be detected by TEM in all specimens, even after 5-min exposure to 1.0% citric acid. It is concluded that the in vivo salivary pellicle can resist the acidic action to some extent and provides protection to the underlying enamel surface against erosive destruction caused by short-term action of citric acid.

Animals↗
PubMedDate not supplied

Protective influence of experimentally formed salivary pellicle on enamel erosion. An in vitro study.

The purpose of this study was to evaluate dental erosion in 0.1 and 1.0% citric acid in vitro by several different methods and to assess the protective potential of experimentally formed salivary pellicle (24 h in vitro). Bovine enamel slabs were embedded in epoxy resin and polished. Erosion was performed in citric acid for 1, 5 or 10 min and recorded as microhardness loss, as changes of surface roughness (R(a), R(t) and R(zDIN)) and as calcium release. Additionally, erosive alterations were observed with scanning electron microscopy. Significant microhardness loss on non-pellicle-covered specimens was measured after 1-min exposure to 0.1% citric acid. Microhardness loss was time- and concentration-dependent. Salivary pellicle significantly inhibited both microhardness loss, except after 10-min immersion in 1.0% citric acid, and significantly reduced the increase of surface roughness. There were, however, no significant differences in calcium release between pellicle-covered and non-covered enamel. The results support the general conclusion that salivary pellicle effectively protects enamel surface against short-term erosion in organic acids.

Analysis of Variance↗
PubMed2007

Effects of calcium on the erosive potential of acidic candies in saliva.

Theoretical calculations have shown that acidic candies may be potentially erosive upon consumption. However, little is known about the protective effect of adding calcium to potentially erosive candies and about the protective effects of saliva that cannot be fully accounted for by theoretical calculations. Therefore, the aims of this study were to (1) determine the erosive potential of acidic candies with and without calcium and (2) to determine differences between theoretically calculated erosive potential and actual erosive potential in saliva. Twenty healthy test persons sucked acidic candy with and without calcium while their whole saliva was collected into a closed system at different times: baseline, candy-stimulated, and post-stimulated. The erosive potential of the candy was evaluated from candy-induced changes in saliva degree of saturation with respect to hydroxyapatite (HAp) and directly by dissolution of HAp crystals in candy-stimulated saliva. The results showed that similar salivary stimulation was obtained with both candies. The modified candy released more than 13 mmol/l of calcium into saliva, resulting in a lower critical pH, and considerably lower erosive potential than the control (p < 0.001). Although a significant correlation was obtained between theoretical calculation of DS(HAp) and dissolution of HAp crystals (r(s) = 0.65; p < 0.001), many samples obtained by sucking modified candy showed no signs of HAp dissolution in spite of being undersaturated. We conclude that saturation levels and critical pH may not fully reflect when dental erosion is expected to occur in saliva and that calcium addition reduces the erosive potential of acidic candies.

Adult↗
PubMed1989

Unexplained losses of enamel on upper incisor teeth.

Consumption of low pH drinks has been steadily increasing, resulting in a number of instances of dental erosion. Such cases can easily be mistaken for attrition, abrasion or development abnormality, delaying proper treatment. In the example reported here the authors describe how differential diagnosis and dietary analysis were used to identify erosion as the cause of enamel loss, and the subsequent successful management of the case.

Beverages↗
PubMed1989

Dental aspects of anorexia and bulimia nervosa.

Anorexia nervosa and bulimia nervosa are both psychosocial pathological eating disorders. An intense preoccupation with food, weight and a distorted body image coupled with a morbid fear of becoming obese are common elements in both syndromes. Self-starvation with extreme weight loss is associated with anorexia nervosa. Bulimia nervosa is characterized by unrestrained eating sprees followed by purging, fasting or vomiting. Approximately 50% of anorexia nervosa patients also practice bulimia. The impact of eating disorders on the oral soft and hard tissues depends upon the diet as well as the duration and frequency of binge-purge behavior. Erosion of the teeth due to frequent regurgitation of highly acidic stomach contents is a common finding. Dental caries development is less predictable and appears to be diet- and oral hygiene-dependent. Painless enlargement of the parotid salivary glands is a common sequela of chronic vomiting but the pathophysiological cause has not been firmly established. The dehydration of the oral soft tissues due to salivary gland impairment in addition to dietary deficiencies and poor oral hygiene can adversely impact the health of the periodontal tissues and oral mucosa. Initial dental care is focused on discouraging behavior that is destructive to the oral tissues. Improved oral hygiene, the use of gastric acid-neutralizing antacid rinses and the daily application of topical fluorides can be useful in reducing enamel erosion. Extensive restorative oral rehabilitation should be postponed until the underlying psychiatric components of the disorder are stabilized.

Adolescent↗
PubMed1994

The acidity (pH) and buffering capacity of Canadian fruit juice and dental implications.

Excessive consumption of acidic fruit juices is associated with dental morbidity. The pH and buffering capacities of fruit juices packaged and consumed in Canada were measured, and the implications on dental pathology of consuming juices of these qualities are discussed. Canadian fruit juices have a pH below the critical dissolving pH of enamel, and have buffering capacities similar to juices produced and consumed elsewhere in the world. Citrus, apple, and grape juice, or blends of these juices, are all potentially hazardous to teeth. Erosion, attrition, decay and dentinal hypersensitivity may all result from abusive juice drinking.

Ascorbic Acid↗
PubMed1996

Longevity of glass-ionomer restorative materials: results of a 10-year evaluation.

Three restorative materials used for cervical erosion /abrasion lesions were evaluated clinically after 10 years. Thirty adult patients with at least four cervical lesions received one restoration of each of Ketac-Fil, finished immediately, Ketac-Fil, finished after a delay, Chelon-FIl (all glass-ionomer cements), and Cervident (a resin composite). Restorations were placed without any tooth preparations. Eighteen patients returned for their 10-year examinations. Two experienced examiners provided the periodic evaluations. Complete retention at 10 years was 83% for Ketac-Fil, finished immediately; 78% for Ketac-Fil, finished after a delay; 67% for Chelon-Fil; and 17% for Cervident. All three glass-ionomer restorative materials exhibited statistically significantly greater retention that did Cervident. When a noninvasive procedure is desired, glass-ionomer materials are the restorative material of choice for abrasion/erosion lesions because of their long-term retention values.

Adult↗
PubMed1987

Dental erosion secondary to ethanol-induced emesis.

Case reports within the dental literature have attributed dental erosion to many factors. Severe dental erosion from chronic vomiting, induced by ethanol abuse, has not been previously documented. This article reports such a history and reviews appropriate intervention by the dental practitioner.

Adult↗
PubMed2002

Dental erosion in a group of British 14-year-old, school children. Part III: Influence of oral hygiene practises.

OBJECTIVES: The aims of this study were firstly to describe the dental history and oral hygiene practises in a cluster random sample of 14-year-old children in Birmingham, UK. The second aim was to determine whether the oral hygiene practises are associated with dental erosion. METHOD: A total of 418, 14-year-old schoolchildren from a cluster random sample in Birmingham, UK were assessed for dental erosion (209 males and 209 females). Data on the dental history and oral hygiene practises were obtained from a self-reported questionnaire supplemented by a structured interview. The data were analysed using SPSS with Mann-Whitney U analyses and odds ratios. RESULTS: 74% of the teenagers claimed to attend the dentist on a six-monthly basis; 60% brushed their teeth twice a day ie before breakfast and last thing at night, 25% once a day, 12% three times or more a day and 3% less than once a day. It was a so found that 28% of the children brushed their teeth after meals; 92% of the children used a manual toothbrush and 56% of them replaced their toothbrush every three-months. The most common technique used by the children was a circular brushing movement; 44% of them used a mouthwash and 40% used other interdental cleaning. Girls brushed their teeth more frequently than boys. Associations were found between dental erosion and brushing teeth last thing at night, after meals, techniques of brushing teeth, and type of toothbrush and frequency of brushing. It was concluded that reported oral hygiene practises in teenage schoolchildren in Birmingham, UK complied with generally recommended guidelines. However, there was an association between dental erosion and some of these oral hygiene practises. Advice concerning the impact of some oral hygiene procedures needs to be given to those who are susceptible to dental erosion.

Adolescent↗
PubMed2006

Exposure time of enamel and dentine to saliva for protection against erosion: a study in vitro.

Previous research, mainly on enamel, supports a protective role for salivary pellicle against erosion. Pretreatments have tended to be lengthy (24 h or more) and of questionable relevance to the regular intake of acidic food and drink by many individuals. The aim of this study in vitro was to determine the protective effect of salivary pellicle formed on enamel and dentine over time periods up to 4 h. Flattened, polished human enamel and dentine specimens were pretreated with unstimulated human saliva from a single donor for 2 min, 30 min (enamel only), 1, 2, or 4 h. Controls were exposed to water for the same times. Specimens were then exposed to 0.3% citric acid, pH 3.2 for 10 min with stirring. This cycle was carried out 12 times. Tissue loss was measured by profilometry after 3, 6, 9 and 12 cycles. For enamel, statistically significant protection was found at >or=1 h. For dentine, significant protection was achieved at 2 min. Salivary pellicle offered proportionately greater protection to enamel than dentine. Cautiously extrapolating these in vitro data suggests that pellicle should offer erosion protection to individuals who imbibe acidic drinks at frequencies of 1 h or less.

Adolescent↗
PubMed1992

Location of dental erosion in a referred population.

The aim of the study reported here was to determine locations of dental erosion and whether or not it is possible to decide the cause of erosion from the location. One hundred and six patients with dental erosion, 54 men and 52 women, mean age of 33.6 years, were studied. Erosion was classified as one of three grades on buccal, lingual or occlusal/incisal surfaces. Dietary and gastric causes of erosion were identified by means of a questionnaire. Erosion was observed on all teeth, but was commonest on the upper incisors, canines and premolars, and severest on palatal surfaces. In both groups, in which erosion had gastric and dietary causes, there were cases of buccal, lingual and occlusal erosion, but the risk of lingual erosion was 1.9 times greater in the group in which erosion had a gastric cause than in the group in which erosion had a dietary cause. Our findings indicate, however, that the cause of dental erosion cannot reliably be identified by location of the lesion.

Adolescent↗